Review of the National Rural Locum Program - Final Report - April 2011

Summary of key findings

Page last updated: 04 July 2012

Key findings for SOLS

Key successes of SOLS

Overall, the SOLS program is a successful program. The program:

  • is meeting steadily growing targets for placements and subsidised days
  • has been successful in building a good supply of locums, especially for specialist obstetricians, which is a critical achievement
  • has high levels of support from both hosts and locums
  • is well known to its target stakeholders
  • has efficient and effective management and administration processes, including an advisory committee who provided expert guidance to the development of SOLS
  • is well supported by RANZCOG
  • provides a service to all states and territories (except ACT) and has a national base of locums from which to draw locum relief
  • provides a level of subsidies which is considered adequate to partially offset the cost to hosts
  • has flexibility to provide placements and subsidies to services/practices most in need.

Key areas for improvement for SOLS

The key areas for improvement identified for the SOLS program are:

  • SOLS in its current form does not cater well for proceduralists with more than one specialty. It is unlikely that potential hosts seeking a locum for a GP with multiple proceduralist skills would look to SOLS to fill the vacancy or indeed that SOLS could fill the vacancy.
  • SOLS has difficulty at times providing locums who require their own private medical indemnity insurance as only approximately 30% of SOLS locums have their own insurance.
  • The SOLS model in its current form does not provide easy access to the subsidies for hosts who are using commercial locum agencies or their own networks for locum relief.

Key findings for GPALS

Key successes for GPALS

For the small number of hosts who accessed the scheme, GPALS provided an effective locum placement with a considerable cost offset.

GPALS has developed appropriate internal processes which were effective during the operation of the program, albeit limited.

Key areas for improvement for GPALS

Key areas which impacted on the success of the GPALS operation are:

  • Misalignment of the model with the way GPAs and hospitals generally source and use anaesthetic locums and resulting in low demand. Specifically:
    • The hospital sector has established relationships with commercial agencies and often uses specialist anaesthetists to fill GPA positions. The availability of the subsidies is not a key incentive for hospitals — rather, the availability of locums is of more importance.
    • GPAs often use private networks to source locum services. Alternatively, they will often only source a locum for the GP component of their role and leave the anaesthetic component to their local hospital to source or manage.
  • Inability to procure a sufficient locum supply.
  • Lack of clarity in relation to the shortage of anaesthetists in rural Australia. The ASA state that the shortage relates mainly to filling permanent positions, rather than the ability to find temporary locum cover.
  • Unsustainable administrative costs per placement due to low numbers.
  • GPALS in its current form does not cater well for proceduralists with more than one specialty.
  • GPALS cannot provide locums at short notice for urgent leave.
  • GPALS in its current form does not provide easy access to subsidies for hosts who are using commercial locum agencies or private networks for locum relief.

Key findings for RGPLP

Key successes for RGPLP

The RGPLP has been successful in terms of meeting its objectives. The program:

  • has met the targets for placements for the July 2010 to June 2011 period within the first 6 months
  • has almost met targeted subsidised days for the same period
  • has been successful in building the supply of locums
  • has high levels of support from both hosts and locums
  • is well known to its target stakeholders given its short duration
  • has effective management and administration processes
  • provides a service to all states and the Northern Territory, and has a national base of locums from which to draw locum relief
  • provides a level of subsidies which is considered adequate to partially offset the cost to hosts of employing locums, although some review of these subsidies is recommended
  • has flexibility to provide placements and subsidies to service/practices most in need due to its concurrent operation with other subsidised locum programs.

Key areas for improvement for RGPLP

The RGPLP, would benefit from the following issues being addressed:

  • the anticipated increasing demand for the program will need to be managed
  • focus on strategies to improve locum supply through collaboration with the Department of Health and Ageing, RACGP and ACRRM
  • the subsidy available for travel time is not considered adequate to appropriately compensate for locum travel time to remote areas
  • the capping of subsidy days could be better tailored depending on the GP’s remoteness and other responsibilities (eg VMO duties)
  • the method of allocation of targets to the RWAs by RHWA should ensure a more targeted approach to those GPs most in need of locum and/or subsidy support
  • as with SOLS and GPALS, the RGPLP does not provide easy access to subsidies for those hosts who are using commercial agencies or their own private networks for locum relief
  • RGPLP targets GPs and therefore does not focus on GP proceduralists. It is unlikely that potential hosts seeking a locum for a GP with multiple proceduralist skills would look to RGPLP to fill the vacancy.